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CASE REPORT article
Front. Pediatr.
Sec. Pediatric Oncology
Volume 13 - 2025 |
doi: 10.3389/fped.2025.1494946
Imaging Manifestations of Pediatric Primary Thymic lymphoepithelioma-like Carcinoma: Case Report of 4 Children with Literature Review
Provisionally accepted- 1 Anhui Provincial Children’s Hospital, Hefei, Anhui Province, China
- 2 Children's Hospital, Fudan University, Shanghai, China
Objective: To analyze the imaging characteristics of lymphoepithelioma-like carcinoma (LELC) in children's thymus. Methods: Four pediatric cases of primary thymic LELC confirmed by needle biopsy pathology from our research center were enrolled. All children underwent an enhanced chest CT examination. In addition, 11 cases of pediatric thymic LELC with CT manifestations reported in the literature over the past 20 years were combined to explore their imaging characteristics. Results: In our research center, there were 4 cases, all male, with an average age of 11.25±2.87 years. CT showed a soft tissue mass in the anterior mediastinum, with the mass being lobulated or roughly circular, and growing laterally. The maximum diameter of the mass was 120mm, with an average of 90±21.6mm. In 3 cases, the mass showed cystic necrosis, which enhanced unevenly, and in 3 cases, small blood vessels were seen traversing the mass. Two cases had an invasion of the pleura and lung with associated pleural effusion. In 2 cases, vascular reconstruction showed blood supply from branches of the internal thoracic artery, with 1 case having spinal metastasis. Combined with literature reports of 11 pediatric cases with thymic LELC, a total of 15 cases of thymic LELC were identified: 13 cases were male, 2 cases were female; the average age was 11.25±2.87 years; the maximum diameter of the lesion was 160mm, with an average of 107±27.78mm; 7 cases had cystic necrosis, 4 cases had calcification; 5 cases did not mention the enhancement method, and the remaining 10 cases showed uneven enhancement; 6 cases had tumor invasion of adjacent large blood vessels, 6 cases had pleural effusion, 5 cases invaded the pleura, 5 cases had metastasis to mediastinal, hilar, or axillary lymph nodes, 5 cases had pulmonary metastasis, and 3 cases had bone metastasis. Conclusion: Thymic LELC in children showed a higher incidence in males. Imaging characteristics of pediatric thymic LELC are manifested as large masses located in the anterior mediastinum, with high malignant features and metastasis.
Keywords: Children, Lymphoepithelioma-like carcinoma, computed tomography, case report, tumor
Received: 11 Sep 2024; Accepted: 22 Jan 2025.
Copyright: © 2025 Zhu, Fang, Wang, Hu, Gu, Yao and Qiao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qiong Yao, Children's Hospital, Fudan University, Shanghai, China
Zhongwei Qiao, Children's Hospital, Fudan University, Shanghai, China
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